PDFIndian Journal of Medical and Paediatric Oncology.pdf
- Published Version
Restricted to Registered users only
Download (4MB)
| Request a copy

Abstract

Context: Recent studies show that enzymatic contents of the neutrophil granules have a remarkable
ability to modulate the tumor microenvironment by causing apoptosis of T‑lymphocytes which
leaves the host’s cell‑mediated immunity at stake. The preoperative neutrophil to lymphocyte
ratio (NLR) is considered to be an indicator of the immune status of the patients with oral
squamous cell carcinoma (OSCC), which will thereby help in predicting the course of the
disease. Aims: The aim is to assess the NLR and histopathological prognostic factors pertinent to
infiltration of the surrounding structures and correlate them with the clinical prognostic outcomes
of OSCC. Settings and Design: This retrospective study involved the retrieval of formalin‑fixed,
paraffin‑embedded, hematoxylin, and eosin‑stained sections of 55 cases of OSCC from the
departmental archives from 2006 to 2014. Subjects and Methods: Grading of each case was
done by Bryne's grading system. The preoperative complete blood counts, relevant case history,
and clinical data of the patients involved in the study were collected from the institutional medical
records. The NLR was calculated by dividing the serum neutrophil count by the serum lymphocyte
count. Statistical Analysis Used: The median NLR was compared between the controls and OSCC
cases using Wilcoxon-signed rank test, and the Kaplan‑Meier survival analysis was carried out to
predict the survival and recurrence status of OSCC. Results: Higher NLR was seen in lymph node
and margin‑involved cases and also in patients who had tumor recurrence. Kaplan‑Meier survival
analysis showed that the mean survival dropped from 26 to 4.5 months when NLR ≥5 (P = 0.052).
Conclusion: Neutrophil‑to‑lymphocyte ratio can be used as a prognosticator of survival, recurrence,
lymph node status, and margin status in OSCC.